Lomonosov Moscow State University

Graduate School of Business Administration

The Study of the Development and the Key Features

of the Health Care System in France

by

Angelika Bondarenko

Academic Research and Writing, Group II

Supervisor Kainova

May 19, 2011

Table of contents

Introduction…………………………………………………………………….......3

1. Historical background…………………………………………………………...5

1.1 Social security system development…………………………………….5

1.2 Hospital development…………………………………………………...6

1.3 Regulation policies development………………………………………..6

2. The organizational structure of the health care system……..…………..……….7

2.1 The state…………………………………………………………………7

2.2 Statutory health insurance funds…..……........………………………….8

2.3 Professional organizations………………………………………………9

2.4 Health care users………………………………………………………...9

3. The management of the health care system…………………..………………...10

3.1 Resource planning……………………………………………………...11

3.2 Financial regulations…………………………………………………...11

4. Health care financing and expenditure……….………………………………...12

4.1 Financing scheme……………………………………………………....12

4.2 Reimbursement…………………………………………………………12

4.3 Complementary sources of financing…………………………………..13

4.4 Health care expenditure………………………………………………...14

Conclusion………………………………………………………………………...15

Reference list……………………………………………………………………...16

Introduction

The topic of this coursework is “The development and the key features of health care system in France”. Health care system (further HC system) is a term that refers to the complete network of agencies, facilities, and all providers of health care in a specified geographic area.

Nowadays health care systems play a significant role in the life of every state as well as in the well-being of their citizens. The standard of living directly depends on the health care provision, as a result governments should draw a lot of attention to this sphere. France has been leading the way in this respect recently. The World Health Organization ranked the French health care system the best in the world. (World Health Organization, 2010)

There are several key features of the French system, which make it efficient. These features had been formed during the whole history of French health care system and they are still developing according to the modern trends.

The mix of public and private providers is the first feature of French HC system. It helps to spread the expenditures among private and governmental services.

The large component of cost sharing is a second major feature of HC system. It is very close to the first one, because it helps to spread costs among governmental and private organizations. The health care costs are paid by the statutory health insurance scheme (in the form of reimbursements or direct payment by the health insurance funds), while the different health insurance funds are financed by contributions based on professional earnings and other forms of income.

Another feature is that the state is the main actor of the health care sector. It plays a direct role in the funding and provision of health care and regulates the relations between funding institutions, patients and health professionals.

All these features are the same as in some other European countries. What makes French system the best, according to the World Health Report 2010 by the World Health Organization, are the principles by which it is functioning: solidarity, liberalism and pluralism. These principles are closely connected with the features of the health care system of France.

The principle of solidarity states that every citizen must be provided with the basic health care. However, in France it also includes the management of a national network of public hospitals, public health programs, and a small number of publicly financed health centers. The principle of liberalism is the notion that there should be freedom of choice for patients and some direct responsibility for payment by patients. Finally, the public-private mix in the financing and provision of health care, in France, rests on the principle of pluralism—the tolerance of some organizational diversity, whether it be complementary, competitive, or both.

This coursework describes the creation and the development of the French health care system, how the three main principles were formed and then implemented in the organization, management and financing of the system. These are the things that make the health care system in France stable and efficient.